Hoarse voice, if it persists for more than 3 weeks , certainly needs to be evaluated as it can be a sign of laryngeal cancer or cancer of your voice box. But no need to panic! Just because your voice has changed its quality , it does not necessarily indicate that you have cancer. Other reasons why your voice may change or become hoarse are – laryngitis (inflammation of larynx), overuse or misuse of voice , acid reflux, allergies, trauma. So how do you know what has actually caused that change in your voice? For this you need to be properly evaluated by your ENT doctor who will infer from a proper and detailed history and examination, and if necessary , relevant investigations; your accurate diagnosis. He may need to do your laryngeal endoscopy to visualise and evaluate your voice box and surrounding structures. An examination of your neck to look for any enlarged lymph nodes, which may again be a sign of cancer is mandatory. If necessary, your ENT doctor will advise further investigations like a CT scan and / or biopsy. Although, most of the time , it is possible that your change of voice may be due to completely benign reasons which are stated above ; and if so, you will be prescribed some medications for your condition. If necessary, you will also be advised to undergo voice therapy for the same. The important thing to remember here is that- if at all you are suffering from a change of voice, please be sure to visit your ENT surgeon and get your condition diagnosed as soon as possible to avoid further complications. Any disease diagnosed in the early stage has the highest chance of recovery. The incidence of laryngeal cancer worldwide currently is 2.76 cases per year per one lakh inhabitants and 1.66 deaths per year per one lakh inhabitants . In India , laryngeal cancer contributes to approximately 3% -6% of all cancers in men. It is one of the 10 leading causes of cancer in Indian men. The 5 year survival rate for laryngeal cancer in India is approximately 28%. The factors most often implicated in the causation of laryngeal cancer according to Indian studies are : Smoking, alcohol consumption, tobacco, long term exposure to indoor air pollution ( from coal/ wood burning ) , spicy food. According to research more than 60% of laryngel squamous cell carcinoma patients were cigarette smokers and nearly 75% of them had smoked for more than 30 years. In more than 75% of cases there was history of alcohol consumption. Change of voice or hoarse voice is not the only symptom of cancer of the larynx. Some of the patients also present with difficulty in swallowing, lump or swelling in the neck , weight loss, some even present with extreme pain in the ear (also known as referred otalgia), in severe cases patients may present with difficulty in breathing. Depending on the stage and type of cancer , it can be treated by surgery (laryngectomy) , radiotherapy , chemotherapy or a combination of the above modalities of treatment. As stressed earlier, the management of laryngeal cancer is easier and the prognosis better if diagnosed early.